Implications for Public Health

Oct 13, 2025 by leolavanderia.com.br 115 views

Identification of Gene Mutations RPOB 522, 526, 531, and 533 Mycobacterium tuberculosis which Causes Rifampicin Resistance in MDR-TB Patients in H. Adam Malik Hospital Medan, North Sumatra, Indonesia

Introduction

Tuberculosis (TB) is a highly infectious disease that is one of the leading causes of death worldwide, with approximately 1.5 million cases reported each year. In Indonesia, the incidence of TB, particularly the drug-resistant form known as Multi-Drug Resistant Tuberculosis (MDR-TB), is a pressing concern. This study aims to identify the mutations in the Mycobacterium tuberculosis gene associated with resistance to rifampicin, the primary drug used in TB treatment. The research was conducted at H. Adam Malik Medan Hospital, focusing on specific codons in mutated RPOB genes, and to determine the pattern of mutations that occur in patients.

The Importance of Identifying Gene Mutations in MDR-TB Patients

The emergence of MDR-TB is a significant public health concern, as it poses a significant challenge to the effective treatment of TB. The development of resistance to rifampicin, a key component of TB treatment, is a major concern, as it can lead to treatment failure and the spread of the disease. Identifying the gene mutations associated with rifampicin resistance is crucial in developing effective treatment strategies and preventing the spread of the disease.

Research Methods

This study was an observational study conducted between July and November 2019. The identification of RPOB gene mutations was carried out using the Multiplex Polymerase Chain Reaction (PCR) technique, which allows for the detection of several mutations at once. This technique is a powerful tool for identifying gene mutations associated with rifampicin resistance.

Results and Discussion

The study involved 30 MDR-TB patients, with 18 (60%) of them being men and 12 (40%) being women. The age distribution showed that the age group 41-50 years was the most common, reaching 30%. In terms of education, most patients had the latest education at the high school level, with a total of 13 patients (43.34%). This highlights the need for a better health education approach, especially for low-educated groups.

Marriage status analysis showed that 25 (83.33%) patients were married, which can be related to TB transmission patterns in the family. Additionally, there was a history of comorbidity diabetes mellitus in 16 (53.33%) patients, which reinforces the relationship between chronic diseases and an increased risk of TB. From the data, 18 (60%) patients also had a history of smoking, which can worsen lung health conditions and increase the risk of TB.

The MDR-TB suspect criteria showed that most cases were recurrence or new, reaching 16 (53.33%) of patients. RPOB gene mutations related to rifampicin resistance were most commonly found in codons 522, 526, 531, and 533, with a percentage of 100%. This shows that the mutation in these locations is an important indicator for the detection and handling of MDR-TB.

Conclusion

This study provides in-depth insight into the profile of MDR-TB patients at H. Adam Malik Medan Hospital, as well as RPOB gene mutation patterns that contribute to rifampicin resistance. The data obtained can help in formulating TB control strategies and more effective therapy development. The relationship between the history of smoking, low education, and comorbidity confirms the need for a multidisciplinary approach in handling TB, as well as the importance of health education in the community to prevent transmission and development of this disease.

Implications for Public Health

The findings of this study have significant implications for public health. The identification of RPOB gene mutations associated with rifampicin resistance can help in developing effective treatment strategies and preventing the spread of the disease. The study highlights the need for a multidisciplinary approach in handling TB, including health education, smoking cessation programs, and comorbidity management. Additionally, the study emphasizes the importance of early detection and treatment of MDR-TB to prevent the spread of the disease.

Future Research Directions

Future research should focus on developing effective treatment strategies for MDR-TB patients with RPOB gene mutations. Additionally, studies should investigate the relationship between RPOB gene mutations and other factors, such as comorbidity and smoking history. Furthermore, research should aim to develop more effective health education programs to prevent the transmission and development of TB in the community.

Limitations of the Study

This study has several limitations. The sample size was relatively small, and the study was conducted in a single hospital. Additionally, the study did not investigate the relationship between RPOB gene mutations and other factors, such as comorbidity and smoking history. Future studies should aim to address these limitations and provide more comprehensive insights into the profile of MDR-TB patients and RPOB gene mutation patterns.

Conclusion

In conclusion, this study provides valuable insights into the profile of MDR-TB patients at H. Adam Malik Medan Hospital and the RPOB gene mutation patterns that contribute to rifampicin resistance. The findings of this study have significant implications for public health and highlight the need for a multidisciplinary approach in handling TB. Future research should focus on developing effective treatment strategies and health education programs to prevent the transmission and development of TB in the community.
Q&A: Identification of Gene Mutations RPOB 522, 526, 531, and 533 Mycobacterium tuberculosis which Causes Rifampicin Resistance in MDR-TB Patients in H. Adam Malik Hospital Medan, North Sumatra, Indonesia

Q: What is the significance of identifying gene mutations in MDR-TB patients?

A: The emergence of MDR-TB is a significant public health concern, as it poses a significant challenge to the effective treatment of TB. The development of resistance to rifampicin, a key component of TB treatment, is a major concern, as it can lead to treatment failure and the spread of the disease. Identifying the gene mutations associated with rifampicin resistance is crucial in developing effective treatment strategies and preventing the spread of the disease.

Q: What is the Multiplex Polymerase Chain Reaction (PCR) technique used in this study?

A: The Multiplex Polymerase Chain Reaction (PCR) technique is a powerful tool for identifying gene mutations associated with rifampicin resistance. This technique allows for the detection of several mutations at once, making it a valuable tool for identifying RPOB gene mutations in MDR-TB patients.

Q: What is the relationship between RPOB gene mutations and rifampicin resistance?

A: The RPOB gene mutations associated with rifampicin resistance are most commonly found in codons 522, 526, 531, and 533. These mutations are an important indicator for the detection and handling of MDR-TB.

Q: What is the significance of the study's findings in terms of public health?

A: The findings of this study have significant implications for public health. The identification of RPOB gene mutations associated with rifampicin resistance can help in developing effective treatment strategies and preventing the spread of the disease. The study highlights the need for a multidisciplinary approach in handling TB, including health education, smoking cessation programs, and comorbidity management.

Q: What are the limitations of the study?

A: This study has several limitations. The sample size was relatively small, and the study was conducted in a single hospital. Additionally, the study did not investigate the relationship between RPOB gene mutations and other factors, such as comorbidity and smoking history. Future studies should aim to address these limitations and provide more comprehensive insights into the profile of MDR-TB patients and RPOB gene mutation patterns.

Q: What are the future research directions?

A: Future research should focus on developing effective treatment strategies for MDR-TB patients with RPOB gene mutations. Additionally, studies should investigate the relationship between RPOB gene mutations and other factors, such as comorbidity and smoking history. Furthermore, research should aim to develop more effective health education programs to prevent the transmission and development of TB in the community.

Q: What is the importance of health education in preventing the transmission and development of TB?

A: Health education is crucial in preventing the transmission and development of TB. The study highlights the need for a multidisciplinary approach in handling TB, including health education, smoking cessation programs, and comorbidity management. Effective health education programs can help in preventing the spread of the disease and reducing the burden of TB in the community.

Q: What is the role of comorbidity in the development of TB?

A: Comorbidity, such as diabetes mellitus, can increase the risk of TB. The study found that 16 (53.33%) patients had a history of comorbidity diabetes mellitus, which reinforces the relationship between chronic diseases and an increased risk of TB.

Q: What is the significance of smoking in the development of TB?

A: Smoking can worsen lung health conditions and increase the risk of TB. The study found that 18 (60%) patients had a history of smoking, which can contribute to the development of TB.

Q: What are the implications of the study's findings for TB control strategies?

A: The findings of this study have significant implications for TB control strategies. The identification of RPOB gene mutations associated with rifampicin resistance can help in developing effective treatment strategies and preventing the spread of the disease. The study highlights the need for a multidisciplinary approach in handling TB, including health education, smoking cessation programs, and comorbidity management.